| NPI | 1235406927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE B SHAHEEN Dentist/Owner 505-722-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NM DD3503) |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2016-12-14 |